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MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN 401k Plan overview

Plan NameMONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN
Plan identification number 623

MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision

401k Sponsoring company profile

MONDELEZ GLOBAL LLC has sponsored the creation of one or more 401k plans.

Company Name:MONDELEZ GLOBAL LLC
Employer identification number (EIN):383869170
NAIC Classification:311900
NAIC Description: Other Food Manufacturing

Additional information about MONDELEZ GLOBAL LLC

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 5108066

More information about MONDELEZ GLOBAL LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
6232022-01-01
6232021-01-01
6232020-01-01
6232019-01-01
6232018-01-01
6232017-01-01CINDY FRIMAN
6232016-01-01JOANNE ARMENIO
6232015-01-01JOANNE ARMENIO
6232014-01-01JOANNE P. ARMENIO
6232013-01-01FILED WITH AUTHORIZED SIGNATURE
6232012-09-01FILED WITH AUTHORIZED SIGNATURE

Plan Statistics for MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN

401k plan membership statisitcs for MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN

Measure Date Value
2022: MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-013,806
Total number of active participants reported on line 7a of the Form 55002022-01-010
Number of retired or separated participants receiving benefits2022-01-014,068
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-014,068
2021: MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-013,397
Total number of active participants reported on line 7a of the Form 55002021-01-010
Number of retired or separated participants receiving benefits2021-01-013,934
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-013,934
2020: MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-013,227
Total number of active participants reported on line 7a of the Form 55002020-01-010
Number of retired or separated participants receiving benefits2020-01-013,397
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-013,397
2019: MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-012,912
Total number of active participants reported on line 7a of the Form 55002019-01-010
Number of retired or separated participants receiving benefits2019-01-013,226
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-013,226
2018: MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-012,529
Total number of active participants reported on line 7a of the Form 55002018-01-010
Number of retired or separated participants receiving benefits2018-01-012,970
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-012,970
2017: MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-012,708
Total number of active participants reported on line 7a of the Form 55002017-01-010
Number of retired or separated participants receiving benefits2017-01-012,747
Number of other retired or separated participants entitled to future benefits2017-01-01882
Total of all active and inactive participants2017-01-013,629
2016: MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-012,195
Total number of active participants reported on line 7a of the Form 55002016-01-010
Number of retired or separated participants receiving benefits2016-01-012,435
Number of other retired or separated participants entitled to future benefits2016-01-01778
Total of all active and inactive participants2016-01-013,213
2015: MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-011,530
Total number of active participants reported on line 7a of the Form 55002015-01-010
Number of retired or separated participants receiving benefits2015-01-011,572
Number of other retired or separated participants entitled to future benefits2015-01-01494
Total of all active and inactive participants2015-01-012,066
2014: MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01993
Total number of active participants reported on line 7a of the Form 55002014-01-010
Number of retired or separated participants receiving benefits2014-01-011,064
Number of other retired or separated participants entitled to future benefits2014-01-01331
Total of all active and inactive participants2014-01-011,395
2013: MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01564
Total number of active participants reported on line 7a of the Form 55002013-01-010
Number of retired or separated participants receiving benefits2013-01-01374
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01374
2012: MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year2012-09-010
Total number of active participants reported on line 7a of the Form 55002012-09-010
Number of retired or separated participants receiving benefits2012-09-01212
Number of other retired or separated participants entitled to future benefits2012-09-010
Total of all active and inactive participants2012-09-01212

Financial Data on MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN

Measure Date Value
2022 : MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$1,063,480
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$925,831
Total income from all sources (including contributions)2022-12-31$14,574,480
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$15,096,859
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$13,457,233
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$14,556,820
Value of total assets at end of year2022-12-31$977,599
Value of total assets at beginning of year2022-12-31$1,362,329
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$1,639,626
Total interest from all sources2022-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$17,660
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$17,660
Administrative expenses professional fees incurred2022-12-31$1,639,626
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$25,000,000
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$3,525,843
Participant contributions at end of year2022-12-31$229,889
Participant contributions at beginning of year2022-12-31$221,570
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$2,994
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-12-31$24
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-12-31$95,907
Liabilities. Value of operating payables at end of year2022-12-31$33,480
Liabilities. Value of operating payables at beginning of year2022-12-31$54,924
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-522,379
Value of net assets at end of year (total assets less liabilities)2022-12-31$-85,881
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$436,498
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$744,716
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$1,140,735
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$555,304
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31Yes
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$11,030,977
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$12,901,929
Liabilities. Value of benefit claims payable at end of year2022-12-31$1,030,000
Liabilities. Value of benefit claims payable at beginning of year2022-12-31$775,000
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31CROWE LLP
Accountancy firm EIN2022-12-31350921680
2021 : MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$925,831
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$972,390
Total income from all sources (including contributions)2021-12-31$16,318,398
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$15,453,478
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$13,720,874
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$16,318,098
Value of total assets at end of year2021-12-31$1,362,329
Value of total assets at beginning of year2021-12-31$543,968
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$1,732,604
Total interest from all sources2021-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$300
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$300
Administrative expenses professional fees incurred2021-12-31$586,957
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$25,000,000
Were there any nonexempt tranactions with any party-in-interest2021-12-31Yes
Amount of non-exempt transactions with any party-in-interest2021-12-31$19,539
Contributions received from participants2021-12-31$3,444,710
Participant contributions at end of year2021-12-31$221,570
Participant contributions at beginning of year2021-12-31$201,577
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-12-31$24
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-12-31$20,202
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$95,907
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$0
Liabilities. Value of operating payables at end of year2021-12-31$54,924
Liabilities. Value of operating payables at beginning of year2021-12-31$37,390
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$864,920
Value of net assets at end of year (total assets less liabilities)2021-12-31$436,498
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$-428,422
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$1,140,735
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$322,189
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$541,318
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31Yes
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$12,873,388
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$13,179,556
Contract administrator fees2021-12-31$1,145,647
Liabilities. Value of benefit claims payable at end of year2021-12-31$775,000
Liabilities. Value of benefit claims payable at beginning of year2021-12-31$935,000
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31CROWE LLP
Accountancy firm EIN2021-12-31350921680
2020 : MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$972,390
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$775,910
Total income from all sources (including contributions)2020-12-31$16,141,841
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$17,051,218
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$15,625,655
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$16,137,201
Value of total assets at end of year2020-12-31$543,968
Value of total assets at beginning of year2020-12-31$1,256,865
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$1,425,563
Total interest from all sources2020-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$4,640
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$4,640
Administrative expenses professional fees incurred2020-12-31$416,550
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$25,000,000
Were there any nonexempt tranactions with any party-in-interest2020-12-31Yes
Amount of non-exempt transactions with any party-in-interest2020-12-31$19,539
Contributions received from participants2020-12-31$3,220,843
Participant contributions at end of year2020-12-31$201,577
Participant contributions at beginning of year2020-12-31$177,307
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$19,539
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-12-31$20,202
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-12-31$1,361
Liabilities. Value of operating payables at end of year2020-12-31$37,390
Liabilities. Value of operating payables at beginning of year2020-12-31$35,910
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$-909,377
Value of net assets at end of year (total assets less liabilities)2020-12-31$-428,422
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$480,955
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$322,189
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$1,078,197
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$3,465,488
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31Yes
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$12,896,819
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$12,160,167
Contract administrator fees2020-12-31$1,009,013
Liabilities. Value of benefit claims payable at end of year2020-12-31$935,000
Liabilities. Value of benefit claims payable at beginning of year2020-12-31$740,000
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31CROWE LLP
Accountancy firm EIN2020-12-31350921680
2019 : MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$775,910
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$775,910
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$1,087,847
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$1,087,847
Total income from all sources (including contributions)2019-12-31$14,259,069
Total income from all sources (including contributions)2019-12-31$14,259,069
Total loss/gain on sale of assets2019-12-31$0
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$14,074,447
Total of all expenses incurred2019-12-31$14,074,447
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$12,668,442
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$12,668,442
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$14,239,023
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$14,239,023
Value of total assets at end of year2019-12-31$1,256,865
Value of total assets at end of year2019-12-31$1,256,865
Value of total assets at beginning of year2019-12-31$1,384,180
Value of total assets at beginning of year2019-12-31$1,384,180
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$1,406,005
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$1,406,005
Total interest from all sources2019-12-31$0
Total interest from all sources2019-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$20,046
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$20,046
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$20,046
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$20,046
Administrative expenses professional fees incurred2019-12-31$502,434
Administrative expenses professional fees incurred2019-12-31$502,434
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$25,000,000
Value of fidelity bond cover2019-12-31$25,000,000
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$2,808,196
Contributions received from participants2019-12-31$2,808,196
Participant contributions at end of year2019-12-31$177,307
Participant contributions at end of year2019-12-31$177,307
Participant contributions at beginning of year2019-12-31$170,264
Participant contributions at beginning of year2019-12-31$170,264
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$1,361
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$1,361
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$2,127
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$2,127
Liabilities. Value of operating payables at end of year2019-12-31$35,910
Liabilities. Value of operating payables at end of year2019-12-31$35,910
Liabilities. Value of operating payables at beginning of year2019-12-31$32,847
Liabilities. Value of operating payables at beginning of year2019-12-31$32,847
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$184,622
Value of net income/loss2019-12-31$184,622
Value of net assets at end of year (total assets less liabilities)2019-12-31$480,955
Value of net assets at end of year (total assets less liabilities)2019-12-31$480,955
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$296,333
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$296,333
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$1,078,197
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$1,078,197
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$1,211,789
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$1,211,789
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$1,295,796
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$1,295,796
Asset value of US Government securities at end of year2019-12-31$0
Asset value of US Government securities at end of year2019-12-31$0
Asset value of US Government securities at beginning of year2019-12-31$0
Asset value of US Government securities at beginning of year2019-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31Yes
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31Yes
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$11,430,827
Contributions received in cash from employer2019-12-31$11,430,827
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$11,372,646
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$11,372,646
Contract administrator fees2019-12-31$903,571
Contract administrator fees2019-12-31$903,571
Liabilities. Value of benefit claims payable at end of year2019-12-31$740,000
Liabilities. Value of benefit claims payable at end of year2019-12-31$740,000
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$1,055,000
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$1,055,000
Did the plan have assets held for investment2019-12-31Yes
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31CROWE LLP
Accountancy firm name2019-12-31CROWE LLP
Accountancy firm EIN2019-12-31350921680
Accountancy firm EIN2019-12-31350921680
2018 : MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$1,087,847
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$1,172,860
Total income from all sources (including contributions)2018-12-31$16,870,699
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$16,553,576
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$15,285,849
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$16,854,587
Value of total assets at end of year2018-12-31$1,384,180
Value of total assets at beginning of year2018-12-31$1,152,070
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$1,267,727
Total interest from all sources2018-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$16,112
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$16,112
Administrative expenses professional fees incurred2018-12-31$453,022
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$25,000,000
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$2,763,080
Participant contributions at end of year2018-12-31$170,264
Participant contributions at beginning of year2018-12-31$222,707
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$2,127
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$103,488
Administrative expenses (other) incurred2018-12-31$5,589
Liabilities. Value of operating payables at end of year2018-12-31$32,847
Liabilities. Value of operating payables at beginning of year2018-12-31$72,860
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$317,123
Value of net assets at end of year (total assets less liabilities)2018-12-31$296,333
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$-20,790
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$1,211,789
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$825,875
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$1,637,238
Asset value of US Government securities at end of year2018-12-31$0
Asset value of US Government securities at beginning of year2018-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31Yes
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$14,091,507
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$13,648,611
Contract administrator fees2018-12-31$809,116
Liabilities. Value of benefit claims payable at end of year2018-12-31$1,055,000
Liabilities. Value of benefit claims payable at beginning of year2018-12-31$1,100,000
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31CROWE LLP
Accountancy firm EIN2018-12-31350921680
2017 : MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$1,172,860
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$1,019,948
Total income from all sources (including contributions)2017-12-31$14,680,774
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$14,853,793
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$13,663,811
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$14,676,028
Value of total assets at end of year2017-12-31$1,152,070
Value of total assets at beginning of year2017-12-31$1,172,177
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$1,189,982
Total interest from all sources2017-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$4,746
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$4,746
Administrative expenses professional fees incurred2017-12-31$268,240
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$25,000,000
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$3,550,197
Participant contributions at end of year2017-12-31$222,707
Participant contributions at beginning of year2017-12-31$188,432
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$103,488
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$368,765
Liabilities. Value of operating payables at end of year2017-12-31$72,860
Liabilities. Value of operating payables at beginning of year2017-12-31$204,948
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$-173,019
Value of net assets at end of year (total assets less liabilities)2017-12-31$-20,790
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$152,229
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$825,875
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$614,980
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$614,980
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$1,625,831
Asset value of US Government securities at end of year2017-12-31$0
Asset value of US Government securities at beginning of year2017-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31Yes
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$11,125,831
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$12,037,980
Contract administrator fees2017-12-31$921,742
Liabilities. Value of benefit claims payable at end of year2017-12-31$1,100,000
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$815,000
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31CROWE LLP
Accountancy firm EIN2017-12-31350921680
2016 : MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$1,019,948
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$720,400
Total income from all sources (including contributions)2016-12-31$11,727,370
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$11,552,876
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$10,942,123
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$11,724,911
Value of total assets at end of year2016-12-31$1,172,177
Value of total assets at beginning of year2016-12-31$698,135
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$610,753
Total interest from all sources2016-12-31$2,459
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Administrative expenses professional fees incurred2016-12-31$321,949
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$25,000,000
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$2,865,884
Participant contributions at end of year2016-12-31$188,432
Participant contributions at beginning of year2016-12-31$147,239
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$368,765
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$116,541
Administrative expenses (other) incurred2016-12-31$27,960
Liabilities. Value of operating payables at end of year2016-12-31$204,948
Liabilities. Value of operating payables at beginning of year2016-12-31$96,400
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$174,494
Value of net assets at end of year (total assets less liabilities)2016-12-31$152,229
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$-22,265
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Investment advisory and management fees2016-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$614,980
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$434,355
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$434,355
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$2,459
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31Yes
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$8,859,027
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$10,942,123
Contract administrator fees2016-12-31$260,844
Liabilities. Value of benefit claims payable at end of year2016-12-31$815,000
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$624,000
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31CROWE HORWATH, LLP
Accountancy firm EIN2016-12-31350921680
2015 : MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$720,400
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$845,660
Total income from all sources (including contributions)2015-12-31$8,221,518
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$7,962,686
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$7,310,336
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$8,220,907
Value of total assets at end of year2015-12-31$698,135
Value of total assets at beginning of year2015-12-31$564,563
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$652,350
Total interest from all sources2015-12-31$611
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Administrative expenses professional fees incurred2015-12-31$274,977
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$25,000,000
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$2,232,858
Participant contributions at end of year2015-12-31$147,239
Participant contributions at beginning of year2015-12-31$119,942
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-12-31$116,541
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$29
Administrative expenses (other) incurred2015-12-31$30,861
Liabilities. Value of operating payables at end of year2015-12-31$96,400
Liabilities. Value of operating payables at beginning of year2015-12-31$127,660
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$258,832
Value of net assets at end of year (total assets less liabilities)2015-12-31$-22,265
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$-281,097
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$434,355
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$444,592
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$444,592
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$611
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31Yes
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$5,988,049
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$7,310,336
Contract administrator fees2015-12-31$346,512
Liabilities. Value of benefit claims payable at end of year2015-12-31$624,000
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$718,000
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31CROWE HORWATH, LLP
Accountancy firm EIN2015-12-31350921680
2014 : MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$845,660
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$555,482
Total income from all sources (including contributions)2014-12-31$5,758,451
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$5,915,235
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$5,469,230
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$5,758,218
Value of total assets at end of year2014-12-31$564,563
Value of total assets at beginning of year2014-12-31$431,169
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$446,005
Total interest from all sources2014-12-31$233
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Administrative expenses professional fees incurred2014-12-31$169,794
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$25,000,000
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$1,612,174
Participant contributions at end of year2014-12-31$119,942
Participant contributions at beginning of year2014-12-31$175,429
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$29
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$12
Administrative expenses (other) incurred2014-12-31$226,443
Liabilities. Value of operating payables at end of year2014-12-31$127,660
Liabilities. Value of operating payables at beginning of year2014-12-31$79,482
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$-156,784
Value of net assets at end of year (total assets less liabilities)2014-12-31$-281,097
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$-124,313
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$444,592
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$255,728
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$255,728
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-12-31$233
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31Yes
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$4,146,044
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$5,469,230
Contract administrator fees2014-12-31$49,768
Liabilities. Value of benefit claims payable at end of year2014-12-31$718,000
Liabilities. Value of benefit claims payable at beginning of year2014-12-31$476,000
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31CROWE HORWATH, LLP
Accountancy firm EIN2014-12-31350921680
2013 : MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$555,482
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$297,332
Total income from all sources (including contributions)2013-12-31$2,363,995
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$3,051,048
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$2,654,927
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$2,363,629
Value of total assets at end of year2013-12-31$431,169
Value of total assets at beginning of year2013-12-31$860,072
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$396,121
Total interest from all sources2013-12-31$366
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Administrative expenses professional fees incurred2013-12-31$260,713
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$25,000,000
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$863,629
Participant contributions at end of year2013-12-31$175,429
Participant contributions at beginning of year2013-12-31$59,767
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$12
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$93
Administrative expenses (other) incurred2013-12-31$20,988
Liabilities. Value of operating payables at end of year2013-12-31$79,482
Liabilities. Value of operating payables at beginning of year2013-12-31$87,332
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$-687,053
Value of net assets at end of year (total assets less liabilities)2013-12-31$-124,313
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$562,740
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$255,728
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$800,212
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$800,212
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$366
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31Yes
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$1,500,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$2,654,927
Contract administrator fees2013-12-31$114,420
Liabilities. Value of benefit claims payable at end of year2013-12-31$476,000
Liabilities. Value of benefit claims payable at beginning of year2013-12-31$210,000
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31CROWE HORWATH, LLP
Accountancy firm EIN2013-12-31350921680
2012 : MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$297,332
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total income from all sources (including contributions)2012-12-31$1,108,317
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$545,577
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$446,618
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$1,108,013
Value of total assets at end of year2012-12-31$860,072
Value of total assets at beginning of year2012-12-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$98,959
Total interest from all sources2012-12-31$304
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
Administrative expenses professional fees incurred2012-12-31$77,356
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$25,000,000
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$108,013
Participant contributions at end of year2012-12-31$59,767
Participant contributions at beginning of year2012-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$93
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$0
Administrative expenses (other) incurred2012-12-31$6,800
Liabilities. Value of operating payables at end of year2012-12-31$87,332
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$562,740
Value of net assets at end of year (total assets less liabilities)2012-12-31$562,740
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$800,212
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$304
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31Yes
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$1,000,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$446,618
Contract administrator fees2012-12-31$14,803
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-12-31No
Liabilities. Value of benefit claims payable at end of year2012-12-31$210,000
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31CROWE HORWATH,LLP
Accountancy firm EIN2012-12-31350921680

Form 5500 Responses for MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN

2022: MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planYes
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planYes
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planYes
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planYes
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planYes
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planYes
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planYes
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planYes
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planYes
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planYes
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: MONDELEZ GLOBAL LLC RETIREE HEALTH AND LIFE BENEFITS PLAN 2012 form 5500 responses
2012-09-01Type of plan entitySingle employer plan
2012-09-01First time form 5500 has been submittedYes
2012-09-01Submission has been amendedNo
2012-09-01This submission is the final filingNo
2012-09-01This return/report is a short plan year return/report (less than 12 months)Yes
2012-09-01Plan is a collectively bargained planYes
2012-09-01Plan funding arrangement – InsuranceYes
2012-09-01Plan funding arrangement – TrustYes
2012-09-01Plan funding arrangement – General assets of the sponsorYes
2012-09-01Plan benefit arrangement – InsuranceYes
2012-09-01Plan benefit arrangement - TrustYes
2012-09-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

SECURIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93742 )
Policy contract number70484
Policy instance 3
Insurance contract or identification number70484
Number of Individuals Covered3579
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $12,569
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $555,304
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees12569
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMMISSIONS
Insurance broker organization code?3
PARAMOUNT HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95189 )
Policy contract number031027
Policy instance 2
Insurance contract or identification number031027
Number of Individuals Covered12
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $344,636
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number18821
Policy instance 1
Insurance contract or identification number18821
Number of Individuals Covered40
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $359,133
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SECURIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93742 )
Policy contract number70484
Policy instance 3
Insurance contract or identification number70484
Number of Individuals Covered3408
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $12,136
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $541,320
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees12136
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMMISSIONS
Insurance broker organization code?3
PARAMOUNT HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95189 )
Policy contract number031027
Policy instance 2
Insurance contract or identification number031027
Number of Individuals Covered15
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $362,826
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number18821
Policy instance 1
Insurance contract or identification number18821
Number of Individuals Covered4
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $35,294
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number18821
Policy instance 1
Insurance contract or identification number18821
Number of Individuals Covered4
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $42,390
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PARAMOUNT HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95189 )
Policy contract number031027
Policy instance 2
Insurance contract or identification number031027
Number of Individuals Covered21
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $324,953
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0224871
Policy instance 3
Insurance contract or identification number0224871
Number of Individuals Covered2992
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,267,498
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number149833-R
Policy instance 3
Insurance contract or identification number149833-R
Number of Individuals Covered2851
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,315,652
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PARAMOUNT HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95189 )
Policy contract number031027
Policy instance 2
Insurance contract or identification number031027
Number of Individuals Covered16
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $251,206
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number18821
Policy instance 1
Insurance contract or identification number18821
Number of Individuals Covered4
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $47,107
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number149833-R
Policy instance 3
Insurance contract or identification number149833-R
Number of Individuals Covered2659
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,635,351
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number18821
Policy instance 1
Insurance contract or identification number18821
Number of Individuals Covered53
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $389,005
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PARAMOUNT HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95189 )
Policy contract number031027
Policy instance 2
Insurance contract or identification number031027
Number of Individuals Covered13
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $201,827
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PARAMOUNT HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95189 )
Policy contract number031027
Policy instance 2
Insurance contract or identification number031027
Number of Individuals Covered11
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $216,561
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number149833-R
Policy instance 3
Insurance contract or identification number149833-R
Number of Individuals Covered2468
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,629,541
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number18821
Policy instance 1
Insurance contract or identification number18821
Number of Individuals Covered51
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $347,155
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number18821
Policy instance 1
Insurance contract or identification number18821
Number of Individuals Covered9
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $39,574
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PARAMOUNT HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95189 )
Policy contract number031027
Policy instance 2
Insurance contract or identification number031027
Number of Individuals Covered26
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $168,993
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number149833-R
Policy instance 3
Insurance contract or identification number149833-R
Number of Individuals Covered1343
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,021,578
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number18821*
Policy instance 1
Insurance contract or identification number18821*
Number of Individuals Covered48
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $362,389
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PARAMOUNT HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95189 )
Policy contract number030881
Policy instance 2
Insurance contract or identification number030881
Number of Individuals Covered9
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $85,093
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number149833-R
Policy instance 3
Insurance contract or identification number149833-R
Number of Individuals Covered835
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $639,424
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE OF OREGON, INC. (National Association of Insurance Commissioners NAIC id number: 95893 )
Policy contract number006689*
Policy instance 4
Insurance contract or identification number006689*
Number of Individuals Covered170
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $3,312,814
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number149833-R
Policy instance 3
Insurance contract or identification number149833-R
Number of Individuals Covered391
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $242,673
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PARAMOUNT HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95189 )
Policy contract number030881
Policy instance 2
Insurance contract or identification number030881
Number of Individuals Covered4
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $21,335
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number18821*
Policy instance 1
Insurance contract or identification number18821*
Number of Individuals Covered40
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $205
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $361,018
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees205
Additional information about fees paid to insurance brokerDENTAL NEW SALES
Insurance broker organization code?3
Insurance broker nameTOWERS WATSON DELWARE INC.(CHICAGO)
UNITEDHEALTHCARE OF OREGON, INC. (National Association of Insurance Commissioners NAIC id number: 95893 )
Policy contract number001542
Policy instance 1
Insurance contract or identification number001542
Number of Individuals Covered190
Insurance policy start date2012-09-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $793,388
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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